Team physician #2. Peroneus brevis transfer for Achilles tendon rupture in athletes

We feel peroneus brevis transfer is especially advantageous for patients interested in sports. We have used this technique in 55 athletes, and to date there have been no re-ruptures (Table 1). Two patients had mild superficial wound problems which did not affect the end result. This method has advantages in comparison with nonoperative treatment and other operative techniques. The danger of re-rupture is avoided and loss of strength minimized because the tendon transfer adds power to the injured triceps. In addition, the proximal retracted triceps is restored to length and securely repaired under physiological tension. Postoperative immobilization in a short leg cast at a right angle plus early weightbearing facilitate rehabilitation. A prolonged period of rehabilitation requiring many months of treatment has not been necessary. The extended rehabilitation and prolonged incapacity necessary to recover from immobilization in the plantarflexed position have been avoided. Early weightbearing helps prevent calf weakness and atrophy. Transferring the peroneal tendon has not resulted in any biomechanical functional imbalance to the foot.